Individual
ANDREA WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3616 N COUNTY ROAD 850 E, OTWELL, IN 47564-8990
(812) 582-0490
Mailing address
3616 N COUNTY ROAD 850 E, OTWELL, IN 47564-8990
(812) 582-0490
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
05/05/2020
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